This is my blog about lupus. How we suffer, what the disease is,and how it is misunderstood. Please read my blog, and learn more about lupus to start spreading the word about this devastating disease.

Lupus

Tuesday, January 3, 2012

What do my blood tests mean?

This is a question almost everyone with lupus will ask especially at the beginning of their journey to better health. Unless you are in the medical field and studied rheumatic diseases, you probably have never heard of some of the blood tests associated with diagnosing, and managing lupus. Due to the complexities of SLE, there are many blood tests that need to be regularly run just to keep track of where, how, and how badly the disease is affecting your body. Lupus can go into any part or organ of the human body, making it impossible to predict, but with the use of proper and continual testing, our specialists can keep track of lupus and manage it properly.

Lupus is difficult to diagnose because of the vagueness of the
symptoms each person might have. There is no single test that can
diagnose lupus. A diagnosis is usually confirmed based on a complete
medical history, reported symptoms, and a physical examination that may
include the following:

Blood test (to detect for certain antibodies that are present in most people with lupus)

Blood and urine tests (to assess kidney function)

Complement test (to measure the level of complement, a
group of proteins in the blood that help destroy foreign substances; low
levels of complement in the blood are often associated with lupus)

Erythrocyte sedimentation rate (also called ESR or sed rate)
- a measurement of how quickly red blood cells fall to the bottom of a
test tube. When swelling and inflammation are present, the blood's
proteins clump together and become heavier than normal. Thus, when
measured, they fall and settle faster at the bottom of the test tube.
Generally, the faster the blood cells fall, the more severe the
inflammation.

C-reactive protein (CRP) - is a protein that is elevated
when inflammation is found in the body. Although ESR and CRP reflect
similar degrees of inflammation, sometimes one will be elevated when the
other is not. This test may be repeated to test your response to
medication.

This information is from a wonderful lupus group I joined years ago, it gives some of the best and most in depth info on lupus. I have not been able to find any other blog or site with better or more SLE facts and details.http://www.itzarion.com/lupusgroup.html

More on CRP rates:

Why the Test is Performed

The CRP test is a general test to check for inflammation in the body. It is not a specific test. That means it can reveal that you have inflammation somewhere in your body, but it cannot pinpoint the exact location.

Determine if anti-inflammatory medicine is working to treat a disease or condition

However, a low CRP level does not always mean that there is no inflammation present. Levels of CRP may not be increased in people with rheumatoid arthritis and lupus. The reason for this is unknown.

A more sensitive CRP test, called a high-sensitivity C-reactive protein (hs-CRP) assay, is available to determine a person's risk for heart disease. Many consider a high CRP level to be a risk factor for heart disease. However, it is not known whether CRP is merely a sign of cardiovascular disease or if it actually plays a role in causing heart problems.

Normal Results

Normal CRP values vary from lab to lab. Generally, there is no CRP detectable in the blood.

Your doctor may also use a highly sensitive test called hs-CRP to help determine your risk of heart disease. According to the American Heart Association:

You are at low risk of developing cardiovascular disease if your hs-CRP level is lower than 1.0mg/L

You are at average risk of developing cardiovascular disease if your levels are between 1.0 and 3.0 mg/L

You are at high risk for cardiovascular disease if your hs-CRP level is higher than 3.0 mg/L

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

A positive test means you have inflammation in the body. This may be due to a variety of different conditions, including:

Blood count:This test measures the amount of
hemoglobin,
red blood cells, white blood cells and platelets in your blood. Results
may indicate you have anemia, which commonly occurs in lupus. Low white
blood cell counts may occur as well.Erythrocyte sedimentation rate:This blood test determines the rate at
which
red blood cells settle to the bottom of a tube. A faster-than-normal
rate
may indicate a systemic disease such as lupus. The sedimentation rate
is
not specific for one disease but may be elevated in lupus, other
inflammatory
conditions or with infection.Kidney and liver assessment:A blood test can assess how well your
kidneys
and liver are functioning. Lupus may affect these organs as well as
other
systemic organs.Urinalysis:An examination of a sample of your urine
may
show an increased protein level, which may occur if lupus has affected
your kidneys.Antinuclear antibody (ANA) test:A positive test for the presence of these
antibodies
.. produced by your immune system .. indicates a stimulated immune
system
and is common if you have lupus or another autoimmune disease. Your
doctor
may advise more specific antibody testing and refer you to a
rheumatologist.
(More info here.. http://www.itzarion.com/lupusana.html
)
Chest X-ray:An image of your chest and pleura, which
surrounds
your lungs, may reveal abnormal shadows or inflammation of your lungs,
which may occur with lupus.Electrocardiogram (ECG):This test measures the pattern of
electrical
impulses generated in your heart. It can help identify irregular
rhythms,
damage to your heart or enlargement of your heart, any of which may
occur
with lupus.Syphilis test:If your doctor orders a syphilis test, it's
not
because he or she thinks you might have syphilis. Rather, a
false-positive
to a syphilis test can indicate antiphospholipid antibodies in your
blood.
The presence of antiphospholipid antibodies has been associated with an
increased risk of blood clots, strokes and recurrent miscarriages.

C-Reactive Protein testC-reactive protein is a test that
measures the
concentration of a protein in blood serum that indicates acute
inflammation.

C-reactive protein is a special type of
protein
produced by the liver that is only present during episodes of acute
inflammation.C-reactive protein is a sensitive marker
of inflammation,
the process whereby the body responds to injury. The most important
role
of CRP is its interaction with the complement system, which is one of
the
body's immunologic defense mechanisms.While this is not a specific test, it
does give
a general indication of acute inflammation. Your health care provider
might
use this test to check for rheumatoid arthritis, rheumatic fever
exacerbations,
lupus flares, or heart problems. The test might also be useful to
monitor
response to therapy.Normally there is no CRP in the blood
serum.What abnormal results mean:Since the CRP is a general test, a positive
CRP
may indicate any of a number of things:

Rheumatoid arthritis

Rheumatic fever

Cancer

Tuberculosis

Pneumococcal pneumonia

Myocardial infarction (Heart attack)

SLE (Lupus)

Positive CRP results also occur during the
last half of pregnancy or with the use of oral contraceptives.

Antinuclear antibody (ANA)
test:ANA stands for Antinuclear Antibody.
This literally
means 'substance against the cell nucleus'. The nucleus is the
'headquarters'
of the living cell, therefore the ANA can damage or destroy cells and
tissues.
If the ANA destroys the nucleus of the cell, the cell dies. If enough
cells
die, then the organ tissue dies.One lab test will not be enough because
of the
systemic nature of lupus. Systemic Lupus Erythematosus (SLE) can affect
many systems, or parts, of the body. The auto-antibody blood tests are
the most helpful for diagnosing lupus. As an autoimmune disease, lupus
causes the body to attack itself. The test causing the most concern and
frustration to the patient, is the Antinuclear antibody (ANA) test.The ANA (anti-nuclear antibodies) blood
test is
one of the ruling factors in diagnosing Lupus, but it is not the only
test
that is considered when diagnosing Lupus. A person can have a positive
ANA and NOT have Lupus. A person can have a negative ANA and still have
all the other clinical symptoms of Lupus. Some medications, infections,
and other diseases can cause the test to be positive. A positive ANA is
just one piece of the diagnosis puzzle. Other auto-antibody tests are
more
specific to lupus.Getting a diagnosis of lupus can take
weeks, or
even years. The clinical history is most important. That's why it's so
important that your doctor is a rheumatologist familiar with treating
lupus.
It is important you keep a record of your symptoms, so you can
tell
the doctor what has been going on.To diagnose lupus, the physician has to
look very
carefully at the titer (number) and pattern of the ANA test. The
pattern
of the cell is the determining factor in whether the diagnosis will be
Lupus, arthritis, polymyositis, scleroderma, or another connective
tissue
disease.What's all this talk about titers?The titer shows how many times the
technician
had to mix fluid from the patient's blood to get a sample free of ANAs.
Thus a titer of 1:640 shows a greater concentration of ANA than 1:320
or
1:160, since it took 640 dilutions of the plasma before ANA was no
longer
detected.A negative ANA is any number LESS than
1:80 (this
is "pronounced" one to 80 parts). (Plasma was diluted 1 part plasma
with
8 parts diluting solution.)Since each dilution involves doubling
the amount
of test fluid, it is not surprising that titers increase rapidly. In
fact,
the difference between titers of 1:160 and 1:320 is only a single
dilution.
And it doesn't necessarily represent a major difference in disease
activity.Lower than 1:20 is considered a negative
result.1:80 is considered a "low positive" and
more
tests should be ordered. 1:16 is considered positive and if SED
rates
and Complement tests are positive, Lupus is considered.1:32 is a definite positive and mean the
disease
is active.1:64 is considered very high and tissue
damage
is imminent.Q1. My question is "What is
considered
a high ANA titer for lupus? My blood work will say 'Titers of 1:160 and
greater should be considered highly suggestive of connective tissue
disease'.
But my ANA's sometimes are 1:160 and 1:320 and then last time it was
less
than 1:40.A1. ANA reports include a
titer (number)
and a pattern. The titer tells us how many times the technician had to
dilute plasma from the patient's blood to get a sample free of the
anti-nuclear
antibodies.Thus, a titer of 1:640 shows a
greater concentration
of anti-nuclear antibodies than a titer of 1:320 or 1:160. ANA titers
go
up and down during the course of the disease, and a high or low titer
does
not necessarily mean the disease is more or less active. A titer
above 1:80 is usually considered positive for lupus.What Does the Stain Pattern Mean?The cells are also examined to determine
the pattern
of the nucleus. Following is a chart indicating which pattern is
associated
with which disease or syndrome:1. Rim Pattern A. Systemic Lupus
Erythematosus
(Most Specific)2. Homogenous Pattern A. Systemic Lupus
Erythematosus
(Very specific) B. Tests for Further
evaluation
1.
Anti-dsDNA
2.
Anti-ssDNA
3.
Anti-Smith3. Speckled Pattern A. Most common, least
specific B. Disorders Indicated
1. Systemic Lupus Erythematosus
2. Mixed Connective Tissue Disease
3. Scleroderma
4. Sjogren's Syndrome C. Tests for Further
evaluation
1. Smith Antibody (Anti-Smith)
2. Ribonucleoprotein Antibody (Anti-RNP)
3. Scl-70 kD kinetochore (Anti-Topoisomerase I)
4. Anti-La (Anti-SSB)4. Nucleolar Pattern A. Disorders
1. Scleroderma
2. CREST syndrome B. Further evaluation
1.
Scl-70 kD kinetochore (Anti-Topoisomerase I)
2.
PM-15. Diffuse Pattern A. Non-specific pattern6. Centromere Pattern A. Seen in PSS with
CREST
syndromeQ2. My rheumatologist doesn't
help much
because he goes a lot by whether my sed or sedimentation, rate is
elevated
and other factors. I always have ANA titers in speckled pattern - do
not
know what that is either?A2. The pattern of the ANA
test can
sometimes be helpful in determining which autoimmune disease is present
and which treatment program is appropriate. The speckled pattern is
found
in SLE and other connective tissue diseases, while the peripheral or
rim
pattern is found almost exclusively in SLE. Because the ANA is positive
in so many conditions, the results of the ANA test have to be
interpreted
in light of the patient's medical history, as well as his or her
clinical
symptoms. Thus a positive ANA alone is NEVER enough to diagnose lupus.
On the other hand, a negative ANA argues against lupus, but does not
rule
the disease out completely.Remember the big picture in the process
of diagnosing
Lupus.Diagnostic tools include:

One or more of these tests may be
positive in some
people with lupus Syphilis test - may be falsely positive in people
with
lupus

Skin or kidney biopsy

Getting a diagnosis of lupus can be a
pain-staking
process. However, sometimes isn't it just better to know? Symptoms are
managed for many with anti-inflammatory medications, and drugs to
dampen
down the immune system, like Plaquenil. Your doctor may want a definite
diagnosis before proceeding with the treatment. Lupus is no longer a
death
sentence.From: Laboratory Tests Used in the
Diagnosis of
Lupus Morris Reichlin, M.D., Professor of Medicine and Chief,
Immunology
Section, University of Oklahoma Health Sciences Center, Oklahoma City,
OK. Published by the Lupus Foundation of America.

Blood count:This test measures the amount of
hemoglobin,
red blood cells, white blood cells and platelets in your blood. Results
may indicate you have anemia, which commonly occurs in lupus. Low white
blood cell counts may occur as well.Erythrocyte sedimentation rate:This blood test determines the rate at
which
red blood cells settle to the bottom of a tube. A faster-than-normal
rate
may indicate a systemic disease such as lupus. The sedimentation rate
is
not specific for one disease but may be elevated in lupus, other
inflammatory
conditions or with infection.Kidney and liver assessment:A blood test can assess how well your
kidneys
and liver are functioning. Lupus may affect these organs as well as
other
systemic organs.Urinalysis:An examination of a sample of your urine
may
show an increased protein level, which may occur if lupus has affected
your kidneys.Antinuclear antibody (ANA) test:A positive test for the presence of these
antibodies
.. produced by your immune system .. indicates a stimulated immune
system
and is common if you have lupus or another autoimmune disease. Your
doctor
may advise more specific antibody testing and refer you to a
rheumatologist.
(More info here.. http://www.itzarion.com/lupusana.html
)
Chest X-ray:An image of your chest and pleura, which
surrounds
your lungs, may reveal abnormal shadows or inflammation of your lungs,
which may occur with lupus.Electrocardiogram (ECG):This test measures the pattern of
electrical
impulses generated in your heart. It can help identify irregular
rhythms,
damage to your heart or enlargement of your heart, any of which may
occur
with lupus.Syphilis test:If your doctor orders a syphilis test, it's
not
because he or she thinks you might have syphilis. Rather, a
false-positive
to a syphilis test can indicate antiphospholipid antibodies in your
blood.
The presence of antiphospholipid antibodies has been associated with an
increased risk of blood clots, strokes and recurrent miscarriages.

EXPLAINING BLOOD TESTS

Complete Blood Count (CBC):White Cell Count relates to the
body's
immune system. Recent colds, allergies, infections, or chemical
exposures
may cause this value to be high or low.Red Cell Count refers to the red
blood
cells. These cells carry oxygen in the blood. Low values are commonly
seen
in individuals with certain types of anemia.Hemoglobin (HgB) is the oxygen
carrying
component in the red blood cell. It is formed in the bone marrow. Low
values
are commonly seen in individuals with certain types of anemia.Hematocrit (Hct) - is the volume
(percentage)
of red blood cells in whole blood. Low values are commonly seen in
individuals
with certain types of anemia.MCV stands for mean cell volume.
This is
a measure of the average size of the red blood cells.MCH stands for mean cell
hemoglobin. This
is a measure of the amount of hemoglobin associated with each red cell.MCHC stands for mean cell
hemoglobin concentration.
This value represents the mean hemoglobin concentration in each red
blood
cell.Platelet Count refers to the disk
shaped
structures found in the blood, primarily known for their role in the
coagulation
process.Neutrophils, Lymphocytes, Monocytes,
Eosinophils,
and Basophils are the different types of white blood cells. A
detailed
look at all of the white cells will provide a physician with useful
information
regarding the status of the immune system.RBC Morphology refers to the size
and the
shape of the red blood cells obtained in your blood sample.Blood Chemistry Panel:Glucose is a measure of sugar
content in
your blood. This value is watched closely to evaluate diabetes or
hypoglycemia.
This test needs to be performed in a fasted(no eating) state. Your
blood
sugar should be between 60-120 mg/dl to be considered normal.Urea Nitrogen (BUN) is a waste
product
of protein metabolism. It is produced in the liver and excreted by the
kidneys. When protein metabolism is not working properly, high values
may
occur. Low values need not always be followed with your personal
physician.Creatinine is another waste
product of
protein metabolism. It represents the function of the kidneys. A low
value
is not clinically significant.Iron is the most sensitive
indicator of
your iron stores (in the absence of liver disease or inflammation). Low
values may represent certain types of anemia and should be evaluated by
your personal physician.Calcium is involved in many
physiologic
processes. A normal blood calcium level is essential for normal
function
of the heart, nerves, and muscles. It is also involved in the
coagulation
process.Phosphorus is an essential
element in the
diet. It is a major component of the mineral phase of bone and occurs
in
all tissues, being involved in almost all metabolic processes. Calcium
is controlled by the kidneys and parathyroid glands. Processing errors
may affect this value.Uric Acid is a constituent in the
blood
which transports nitrogen in the body. It is normally excreted in the
urine
to rid the body of nitrogen. Values that are high may indicate gout,
arthritis
or certain kidney problems. A low value is not clinically significant.Sodium is an ion that is
important in the
conduction of nerves, contraction of muscles, and functioning of cells.
It is controlled primarily by the kidneys and adrenal glands.Potassium is important for
muscles and
nerves to function properly. It is controlled by the kidneys. This
value
is watched very closely if one is taking diuretics or cardiovascular
medications.
If the blood sample is not processed properly, high values may occur.Chloride, like sodium and
potassium, is
an ion that is important in the functioning of cells. It is primarily
controlled
by the kidneys and adrenal glands.Total Protein is the total amount
of protein
circulating in the blood. This value represents your general
nutritional
habits.Albumin is a carbohydrate-free
plasma protein
which transports fatty acids, bilirubin, and poorly saturated hormones.
It also serves as a reserve store of protein. High values are not
clinically
significant.Globulin is a protein fraction.
Elevated
values may indicate chronic infections and should be followed-up by
your
personal physician.A/G Ratio is a ratio between
Albumin and
Globulin. Provided Albumin and Globulin values are normal, a high or
low
ratio is not significant.Total Bilirubin is a bile
pigment. It normally
circulates in the plasma and is taken up by liver cells. High levels of
bilirubin may result in jaundice.LDH stands for lactate
dehydrogenase. It
is an enzyme involved in the breakdown of lactic acid. Anything which
causes
cellular damage, including heart attacks, liver disease, and blood
drawing
itself, may cause higher values.Alkaline Phosphatase is an enzyme found
primarily
in bones and the liver. Values for pregnant women have found to be
elevated,
however low values are probably not significant.SGOT stands for serum glutamic
oxaloacetic
transaminase.SGOT is a liver enzyme involved
in cellular
functions of the heart muscle and liver. Alcohol consumption, liver
disease,
and other normal factors have been shown to raise this value. Low
values
are probably not clinically significant.SGPT stands for serum glutamic
pyruvic
transaminase. SGPT, like SGOT, is an enzyme involved in the functions
of
heart, liver, and muscle cells. Alcohol consumption has been shown to
increase
this value.GGT stands for Gamma Glutamyl
Transpedtidase.
Similar to SGOT and SGPT, GGT is an enzyme involved in the function of
the liver, heart, and muscle cells. Alcohol consumption, liver disease,
heart attacks, recent heavy physical exertion, and other normal factors
have been shown to raise this value. Low values are probably not
significant.Cholesterol is used to make
essential body
substances, such as cell walls and hormones. High levels of cholesterol
have been associated with an increased risk for heart disease. Low
levels
of cholesterol are preferred.Triglycerides are blood fats that
are the
usual storage form of lipids in the body. This value can be
dramatically
affected by a recent meal or recent physical activity. Thus, an eight
hour
fast with no significant activity is required for accurate results.HDL Cholesterol is a High Density
Lipoprotein,
which is commonly referred to as the "good" cholesterol. HDL
Cholesterol
is a transport protein that carries cholesterol away from the artery
walls
for removal from the body. The higher the HDL value, the lower the risk
of cardiovascular disease. Exercise and weight loss have been shown to
increase your HDL level, while smoking has been shown to decrease it.LDL Cholesterol is a Low Density
Lipoprotein,
which is commonly referred to as the "bad" cholesterol. LDL
Cholesterol,
like HDL Cholesterol, is a transport protein. However, LDL transports
cholesterol
to the arteries. The lower the LDL Cholesterol concentration, the lower
the risk of cardiovascular disease. A low-fat, low-cholesterol
diet
has been shown to decrease this value.Cholesterol/HDL Ratio is a ratio
of Total
Cholesterol to HDL Cholesterol. This ratio has been shown to be a good
predictor of cardiovascular disease risk, with the lower the ratio the
better. Combinations of regular aerobic exercise and good nutritional
practices
have been shown to improve this ratio.Hematology:HEMATOCRIT (HCT)Hematocrit is the percentage of red blood
cells
in whole blood. It is an important determinant of anemia (decreased),
polycythemia
(decreased), dehydration (elevated), increased R.B.C. breakdown in the
spleen (elevated), or possible dehydration (elevated). The word
hematocrit
means, 'to separate blood,' a procedure followed after the blood is
drawn
through the proper use of a centrifuge.Normal Adult Female Range: 37 - 47% Optimal
Adult
Female 42%Normal Adult Male Range 40 - 54% Optimal
Adult
Male: 47Normal Newborn Range: 50 - 62% Optimal
Newborn
Reading: 56HEMOGLOBIN (HGB)Hemoglobin is the main transport of oxygen
and
carbon dioxide in the blood. It is composed of globin a group of amino
acids that form a protein and heme which contains iron atoms and the
red
pigment, porphyrin. As with Hematocrit, it is an important determinant
of anemia (decreased), dehydration (increased), polycythemia
(decreased),
poor diet/nutrition, or possibly a malabsorption problem.Normal Adult Female Range: 12 - 16% Optimal
Adult
Female: 14Normal Adult Male Range: 14 - 18% Optimal
Adult
Male Reading: 16Normal Newborn Range: 14 - 20% Optimal
Newborn
Reading: 17MCH (Mean Corpuscular Hemoglobin)MCH = Hemoglobin x 10/R.B.C. Mean
Corpuscular
Hemoglobin (MCH) gives the average weight of hemoglobin in the red
blood
cell. Due to its use of red blood cells in its calculation, MCH is not
as accurate as MCHC in its diagnosis of severe anemias. Decreased MCH
is
associated with microcytic anemia. Increased MCH is associated with
macrocytic
anemia.Normal Adult Range: 27 – 33 pg Optimal
Adult
Reading: 30MCV (Mean Corpuscular Volume)MCV = Hematocrit x 10/R.B.C. The Mean
Corpuscular
Volume reflects the size of red blood cells by expressing the volume
occupied
by a single red blood cell. Increased readings may indicate macrocytic
anemia, Pyridoxine or Folic Acid deficiency. Decreased readings may
indicate
microcytic anemia, possibly caused by iron deficiency.Normal Adult Range: 80 - 100 fl Optimal
Adult
Reading: 90Higher ranges are found in newborns and
infantsMCHC (Mean Corpuscular Hemoglobin
Concentration)MCHC = Hemoglobin x 100/Hematocrit This
test
measures the average concentration of hemoglobin in red blood cells. It
is valuable in evaluating therapy for anemia because Hemoglobin and
Hematocrit
instead of R.B.C. are used in the calculation. Low MCHC means that a
unit
of packed R.B.C.’s contains less hemoglobin than normal and a high MCHC
means that there is more hemoglobin in a unit of R.B.C.'s. Increased
MCHC
is seen in spherocytosis, and not seen in pernicious anemia. Decreased
levels may indicate iron deficiency, blood loss, B6 deficiency of
thalassemia.Normal Adult Range: 32 - 36 % Optimal Adult
Reading:
34Higher ranges are found in newborns and
infantsR.B.C. (Red Blood Cell Count)The red blood cells main function is to
carry
oxygen to the tissues and to transfer carbon dioxide to the lungs. This
process is possible through the R.B.C. containing hemoglobin which
combines
easily with oxygen and carbon dioxide.Normal Adult Female: 3.9 - 5.2 mill/mcl
Optimal
Adult Female: 4.55Normal Adult Male Range: 4.2 - 5.6 mill/mcl
Optimal
Adult Male: 4.9Lower ranges are found in Children,
newborns
and infants Immune SystemW.B.C. (White Blood Cell Count)The white blood cell's main function is to
fight
infection, defend the body by phagocytosis against invasion by foreign
organisms, and to produce, or at least transport and distribute,
antibodies
in the immune response. There are a number of types of leukocytes (see
differential) that are classified as follows; Granulocytes
Nongranulocytes
Band Neutrophils Lymphocytes Neutrophils Monocytes Eosinophils BasophilsEach cell, or leukocyte, has a different
job in
the body, which is explained in the Differential section. An increase
in
all types of white blood cells simultaneously is rarely seen. Some
diseases
such as measles, pertussis and sepsis, have increased white blood cell
counts so high that it suggests leukemia. This is a type of temporary
leukocytosis
which must be distinguished from leukemia by running more than one
blood
test.Other potential causes of leukocytosis
include
leukemia, malignancies, drugs, toxins, tissue necrosis and polycythemia
vera. Decreased levels of white blood cells, leukopenia, may occur
during
certain viral infections, hypersplenism, drugs, primary bone disorders,
fungal infections, metastatic tumors, and iron deficiency anemia.Normal Adult Range: 3.8 - 10.8 thous/mcl
Optimal
Adult Reading: 7.3Higher ranges are found in children,
newborns
and infants.NEUTROPHILS NEUTROPHIL COUNTAlso known as Granulocytes or
segmented
neutrophils, this is the main defender of the body against infection
and
antigens. High levels may indicate an active infection. A low count may
indicate a compromised immune system or depressed bone marrow (low
neutrophil
production).Normal Adult Range: 48 - 73 % Optimal Adult
Reading:
60.5Normal Children's Range: 30 - 60 % Optimal
Children's
Reading: 45LYMPHOCYTES LYMPHOCYTE COUNTLymphocytes are involved in protection of
the
body from viral infections such as measles, rubella, chickenpox, or
infectious
mononucleosis. Elevated levels may indicate an active viral infection.
Depressed levels may indicate an exhausted immune system or an active
infection
if the neutrophils are elevated.Normal Adult Range: 18 - 48 % Optimal Adult
Reading:
33Normal Children's Range: 25 - 50 % Optimal
Children's
Reading: 37.5MONOCYTES MONOCYTE COUNTThese cells are helpful in fighting severe
infections,
are considered the body's second line of defense against infection and
are the largest cells in the blood stream. Elevated levels are seen in
tissue breakdown, chronic infections, carcinomas, leukemia (monocytic)
and lymphomas. Low levels may be indicative of a state of good health.Normal Adult Range: 0 - 9 % Optimal Adult
Reading:
4.5EOSINOPHILS EOSINOPHIL COUNTEosinophils are used by the body to protect
against
allergic reactions and parasites. Therefore, elevated levels may
indicate
an allergic response. A low count is normal. Normal Adult Range: 0 - 5
% Optimal Adult Reading: 2.5BASOPHILS BASOPHIL COUNTBasophilic activity is not fully understood
but
it is known to carry histamine, heparin and serotonin. High levels are
found in allergic reactions. Low levels are normal.Normal Adult Range: 0 - 2 % Optimal Adult
Reading:
1LIPIDS:CHOLESTEROLCholesterol is a critical fat that is a
structural
component of cell membrane and plasma lipoproteins, and is important in
the synthesis of steroid hormones, glucocorticoids, and bile acids.
Mostly
synthesized in the liver, some is absorbed through the diet, especially
one high in saturated fats. High density lipoproteins (HDL) is desired
as opposed to the low density lipoproteins (LDL), two types of
cholesterol.
Elevated cholesterol has been seen in artherosclerosis, diabetes,
hypothyroidism
and pregnancy. Low levels are seen in depression, malnutrition, liver
insufficiency,
malignancies, anemia and infection.Normal Adult Range: 120 - 240 mg/dl Optimal
Adult
Reading: 180TRIGLYCERIDESTriglycerides, stored in adipose tissues as
glycerol,
fatty acids and monoglyceroids, are reconverted as triglycerides by the
liver. Ninety percent of the dietary intake and 95% of the fat stored
in
tissues are triglycerides. Increased levels may be present in
artherosclerosis,
hypothyroidism, liver disease, pancreatitis, myocardial infarction,
metabolic
disorders, toxemia, and nephrotic syndrome. Decreased levels may be
present
in chronic obstructive pulmonary disease, brain infarction,
hyperthyroidism,
malnutrition, and malabsorption.Normal Adult Range: 0 - 200 mg/dl Optimal
Adult
Reading: 100LDL (Low Density Lipoprotein)LDL is the cholesterol rich remnants of the
lipid
transport vehicle VLDL (very-low density lipoproteins). There have been
many studies showing correlations between high levels of LDL and
arterial
artherosclerosis. Due to the expense of direct LDL measurement, a
calculation
known as the Friedewald formula is used (Total Cholesterol - HDL
Cholesterol
- Triglycerides/5). When Triglyceride levels are greater than
400,
this method is not accurate.Increased levels are seen in high
cholesterol
diets, nephrotic syndromes, multiple myeloma, hepatic obstruction or
disease,
anorexia nervosa, diabetes chronic renal failure, and premature
coronary
heart disease. Decreased levels are associated with Tangier disease,
Apo-C-II
deficiency, hyperthyroidism, chrnic anemias, hepatocellular disease,
Reye's
syndrome, acute stress, inflammatory joint disease, and chronic
pulmonary
disease.Normal Adult Range: 62 - 130 mg/dl Optimal
Adult
Reading: 81 mg/dlHDL (High Density Lipoprotein)HDL is the cholesterol carried by alpha
lipoproteins.
A high level of HDL is an indication of a healthy metabolic system if
there
is no sign of liver disease or intoxication. Two mechanisms explain how
HDL offers protection against chronic heart disease.First, HDL inhibits cellular uptake of
LDL. Second,
it serves as a carrier that removes cholesterol from the peripheral
tissues
and transports it back to the liver for catabolism and excretion.
Decreased
levels are associated with an increased risk for coronary heart
disease,
poorly controlled diabetes mellitus, hypertriglycerdemia,
hepatocellular
diseases, chronic renal failure and nephrotic syndrome.Normal Adult Range: 35 - 135 mg/dl Optimal
Adult
Reading: 85 mg/dlCHOLESTEROL/HDL RATIOAccording to data from LabCorp of America,
Data
from various studies suggest that the ratio of total cholesterol/HDL
may
provide a 'rule of thumb' guide to predicting increased risk to
coronary
heart disease.Normal Adult Range: 1 - 6 Optimal Adult
Reading:
3.5ENZYMES AND HEPATIC FUNCTION:BILIRUBIN, TOTALA byproduct of the breakdown of red blood
cells
in the liver, bilirubin is a good indication of the liver's function.
Excreted
into the bile, bilirubin gives the bile its pigmentation. Elevated in
liver
disease, mononucleosis, hemolytic anemia, low levels of exposure to the
sun, and toxic effects of some drugs. Decreased levels are seen in
people
with an inefficient liver, excessive fat digestion, and possibly a diet
low in nitrogen bearing foods.Normal Adult Range 0 - 1.3 mg/dlSGOT (SERUM GLUTAMIC-OXALOCETIC
TRANSAMINASE
- AST)Serum Glutamic Oxalocetic Transaminase or
AST
is an enzyme found primarily in the liver, heart, kidney, pancreas, and
muscles. Elevated levels are round n tissue damage, especially heart
and
liver. Decreased levels can be found in Vitamin B deficiency and
pregnancy.Normal Adult Range: 0 - 42 U/L Optimal
Adult
Reading: 21SGPT (SERUM GLUTAMIC-PYRUVIC
TRANSAMINASE -
ALT)Serum Glutamic Pyruvic Transaminase or ALT
is
an enzyme found primarily in the liver but also in the heart and other
tissues. It is more useful in diagnosing liver function than SGOT
levels
are. Decreased SGPT in combination with increased cholesterol levels is
seen in congested liver cases. Increased levels are seen in
mononucleosis,
alcoholism, liver damage, kidney infection, chemical pollutants or
myocardial
infarction.Normal Adult Range: 0 - 48 U/L Optimal
Adult
Reading: 24ALKALINE PHOSPHATASEProduced in the cells of bone and the liver
with
some activity in the kidney, intestine, and placenta, it is mostly
found
in an alkaline state with a pH of 9. Increased levels are seen
extensively
as a tumor marker, in bone injury, pregnancy, or skeletal growth
(elevated
readings). Growing children have normally higher levels of this enzyme.
Decreased levels are sometimes found in hypoadrenia, protein
deficiency,
malnutrition and a number of vitamin deficiencies. Normal Adult Range:
20 - 125 U/L Optimal Adult Reading: 72.5Normal Children's Range: 40 - 400 U/L
Optimal
Children's Reading: 220GGT (GAMMA-GLUTAMYL TRANSPEPTIDASE)GGT is believed to be involved in the
transport
of amino acids and peptides into cells as well as glutathione
metabolism.
GGT is mainly found in liver cells and as such is extremely sensitive
to
alcohol use. Elevated levels may be found in liver disease, alcoholism,
bile-duct obstruction, cholangitis, drug abuse, and in some cases
excessive
magnesium ingestion. Decreased levels can be found in hypothyroidism,
hypothalamic
malfunction and low levels of magnesium.Normal Adult Female Range: 0 - 45 U/L
Optimal
Female: 22.5Normal Adult Male Range: 0 - 65 U/L Optimal
Male:
32.5LDH (LACTIC ACID DEHYDROGENASE)Lactic acid dehydrogenase is an
intracellular
enzyme found primarily in the kidney, heart, skeletal muscle, brain,
liver
and lungs. Increases are usually found in cellular death and/or leakage
from the cell. In some cases it can be useful in confirming myocardial
or pulmonary infarction (only in relation to other tests). Decreased
levels
of the enzyme may be seen in cases of malnutrition, hypoglycemia,
adrenal
exhaustion, or low tissue or organ activity.Normal Adult Range: 0 - 250 U/L Optimal
Adult
Reading: 125ELECTROLYTES:SODIUMSodium is the most abundant cation in the
blood
and its chief base. It functions in the body to maintain osmotic
pressure,
acid-base balance and to transmit nerve impulses. Increased levels are
associated with dehydration, Conn's syndrome, primary aldosteronism,
coma,
Cushing's disease, diabetes insipidus, and tracheobronchitis. Decreased
levels are seen in severe burns, congestive heary failure, excessive
fluid
loss, Addison?s disease, severe nephritis, pyloric obstruction,
malabsorption,
diabetic acidosis, diuretics, edema, and hypothyroidism.Normal Adult Range: 135-146 mEq/L Optimal
Adult
Reading: 140.5POTASSIUMPotassium is the major intracellular cation
in
the blood. It, along with sodium, helps to maintain osmotic balance and
in also involved in acid-base balance. It is needed for proper nerve
and
muscle action. Increased potassium is sometimes seen in renal failure,
dehydration, obstruction, trauma, cell damage, Addison?s disease,
uncontrolled
diabetes and decreased insulin. Decreased levels are associated with
diarrhea,
starvation, vomiting, stress, malabsorption, severe burns, primary
aldosteronism,
excessive licorice ingestion, respiratory alkalosis, renal tubular
acidosis,
drugs, and treatment of megaloblastic anemia with vitamin B12 or folic
acid..Normal Range: 3.5 - 5.5 mEq/L Optimal Adult
Reading:
4.5CHLORIDEChlorides significance relates to its
maintenance
of cellular integrity through it influence on osmotic pressure. It also
helps monitor acid-base balance and water balance. Elevated levels are
related to acidosis and excessive water crossing the cell membrane.
Decreased
levels with decreased serum albumin may indicate water deficiency
(edema).Normal Adult Range: 95-112 mEq/L Optimal
Adult
Reading: 103CO2 (Carbon Dioxide)The CO2 level is related to the respiratory
exchange
of carbon dioxide in the lungs and is part of the body's buffering
system.
Generally when used with the other electrolytes, it is a good indicator
of acidosis and alkalinity. Elevated CO2 is seen in severe vomiting,
emphysema,
aldosteronism and the use of mercurial diuretics. Decrease CO2 is
associated
with severe diarrhea, starvation, acute renal failure, salicylate
toxicity,
and diabetic acidosis.Normal Adult Range: 22-32 mEq/L Optimal
Adult
Reading: 27Normal Children's Range - 20 - 28 mEq/L
Optimal
Children's: 24CALCIUMThe most abundant mineral in the body, it
is
involved in bone metabolism, protein absorption, fat transfer, muscular
contraction, transmission of nerve impulses, blood clotting and
cardiac
function. It is highly sensitive to elements such as magnesium, iron,
and
phosphorus as well as hormonal activity, vitamin D levels, alkalinity
and
acidity, and many drugs.Increased calcium levels may be
associated with
hyperparathyroidism, metastatic bone cancers, cancers of the lung,
breast,
thyroid, kidney, liver, and pancreas as well as Hodgkin's disease,
lymphomas,
leukemia, multiple myelomas, primary squamous cell carcinomas,
tuberculosis,
sarcoidosis, hyperthyroidism, Paget's disease, bone fractures,
excessive
vitamin D intake, and renal transplant.Decreased levels are associated with
hypoparathyroidism,
hyperphosphatemia, malabsorption, acute pancreatitis, renal failure,
alkalosis,
osteomalacia, vitamin D deficiency, malnutrition and alcoholism.Normal Adult Range: 8.5-10.3 mEq/dl Optimal
Adult
Reading: 9.4Normal Children's Reading: 9-11 mEq/dl
Optimal
Children's: 10PHOSPHORUSPhosphorus is an abundant element found in
most
tissues and cells. It is inversely related to the calcium level. When
calcium
is increased, phosphorus tends to decrease and vice versa. Proper blood
draw procedures are necessary in order to avoid falsely elevated
readings.
Phosphorus is needed for its buffering action, calcium transport and
osmotic
pressure. Increased levels are seen in renal insufficiency,
hypoparathyroidism,
excessive intake of vitamin D, hypocalcemia, bone tumors, Addison's
disease,
acromegaly, and liver disease. Decreased levels are associated with
hyperparathyroidism,
rickets, osteomalacia, vitamin D deficiency, diabetic coma, liver
disease,
dialysis, vomiting, intravenous glucose in a nondiabetic patient,
severe
malnutrition and gram-negative septicemia.Normal Adult Range: 2.5 - 4.5 mEq/dl
Optimal
Adult Reading: 3.5Normal Children's Range: 3 - 6 mEq/dl
Optimal
Children's Range: 4.5NITROGEN B.U.N. (BLOOD UREA NITROGEN)The nitrogen component of Urea, B.U.N. is
the
end product of protein metabolism and its concentration is influenced
by
the rate of excretion. Excessive protein intake, kidney damage, certain
drugs, low fluid intake, intestinal bleeding, exercise or heart failure
can cause increases. Decreased levels may be due to a poor diet,
malabsorption,
liver damage or low nitrogen intake. Normal Adult Range: 7 - 25 mg/dl
Optimal
Adult Reading: 16CREATININECreatinine is the waste product of muscle
metabolism.
Its level is a reflection of the body's muscle mass. Low levels are
sometimes
seen in kidney damage, protein starvation, liver disease or pregnancy.
Elevated levels are sometimes seen in kidney disease, muscle
degeneration,
or some drugs involved in impairment of kidney functionNormal Adult Range: .7 - 1.4 mg/dl Optimal
Adult
Reading: 1.05URIC ACIDUric acid is the end product of purine
metabolism
and is normally excreted through the urine. High levels are noted in
gout,
infections, kidney disease, alcoholism, high protein diets, and with
toxemia
in pregnancy. Low levels may be indicative of kidney disease,
malabsorption,
poor diet, liver damage or an overly acid kidney.Normal Adult Female : 2.5 - 7.5 mg/dl
Optimal
Adult Female : 5.0Normal Adult Male: 3.5 - 7.5 mg/dl Optimal
Adult
Male: 5.5PROTEIN, TOTALProteins are the most abundant compounds in
serum.
The protein makeup of the individual is of important diagnostic
significance
because of proteins involvement in enzymes, hormones and antibodies as
well as osmotic pressure balance, maintaining acid-base balance and as
a reserve source of nutrition for the bodies tissues and muscles. The
major
serum proteins measured are Albumin and Globulin (alpha1, alpha2, beta
and gamma). Decreased levels may be due to poor nutrition, liver
disease,
malabsorption, diarrhea, or severe burns. Increased levels are seen in
lupus, liver disease, chronic infections, alcoholism, leukemia, and
tuberculosis
amongst many others. Careful review of the individual albumin, globulin
and A/G ratios are recommended.Normal Adult Range: 6.0 -8.5 g/dl Optimal
Adult
Reading: 7.25ALBUMINAlbumin is the major constituent of serum
protein
(usually over 50%). It is manufactured by the liver from the amino
acids
taken through the diet. It helps in osmotic pressure regulation,
nutrient
transport and waste removal. High levels are seen in liver disease,
shock,
dehydration, or multiple myeloma. Lower levels are seen in poor diets,
diarrhea, fever, infection, liver disease, inadequate iron intake,
third-degree
burns and edemas or hypocalcemia.Normal Adult Range: 3.2 - 5.0 g/dl Optimal
Adult
Reading: 4.1GLOBULIN (CALCULATED)Globulin, a larger protein than albumin, is
important
for its immunologic responses, especially its gamma portion (IgA, IgG,
IgM, and IgE). Globulins have many diverse functions such as, the
carrier
of some hormones, lipids, metals, and antibodies. When chronic
infections,
liver disease, rheumatoid arthritis, myelomas, and lupus are present,
elevated
levels are seen. You may find lower levels in immune compromised
patients,
poor dietary habits, malabsorption and liver or kidney disease.Normal Adult Range: 2.2 - 4.2 g/dl Optimal
Adult
Reading: 3.2 A/GRATIO (ALBUMIN/GLOBULIN RATIO)
(CALCULATED)A/G ratio is an important indicator of
disease
states although a high level is not considered clinically significant.
Low levels may be indicative of liver disease malabsorption, leukemia,
rheumatoid arthritis, lupus, or bacterial pneumonia.Normal Adult Range: 0.8 - 2.0 Optimal Adult
Reading:
1.9ANION GAP (Sodium + Potassium - CO2 +
Chloride)The anion gap is used to measure the
concentration
of cations (sodium and potassium) and the anions (chloride and CO2) in
the extracellular fluid of the blood. Numerous clinical implications
can
be gathered from the Anion Gap. An increased measurement is associated
with metabolic acidosis due to the overproduction of acids (a state of
alkalinity is in effect). Decreased levels may indicate metabolic
alkalosis
due to the overproduction of alkaloids (a state of acidosis is in
effect).Normal Adult Range: 4 - 14 Optimal Adult
Reading:
9BUN/CREATININEA high reading in this calculation is
normally
indicative of too much BUN being formed. A low reading may show that
the
creatinine is not being cleared effectively by the kidney. This
calculation
is a good measurement of kidney and liver function.Normal Adult Range: 6 -25 Optimal Adult
Reading:
15.5CALCIUM/PHOSPHORUS (Calculated)Due to the delicate balance between calcium
and
phosphorus in the system, this calculation is helpful in noting subtle
and acute imbalances in the relationship between the two elements.
Decreased
levels are seen in some autoimmune disorders like fibromyaligia, while
increased levels are found in over supplementation of Calcium.Normal Adult Range: 2.3 - 3.3 Optimal Adult
Reading:
2.8Normal Children's range: 1.3 - 3.3 Optimal
Children's
Reading: 2.3SODIUM/POTASSIUM (Calculated)These are the two major blood electrolytes,
sodium
is the extracellular cation and potassium is the intracellular cation.
This is an important ratio to review and act upon when subtle or acute
imbalances are noted.Normal Adult Range: 26 - 38 Optimal Adult
Reading:
32THYROID THYROXINE (T4)Thyroxine is the thyroid hormone that
contains
four atoms of iodine. It is used to evaluate thyroid function. It is
the
direct measurement of total T4 concentration in the blood serum.
Increased
levels are found in hyperthyroidism, acute thyroiditis, and hepatitis.
Low levels can be found in Cretinism, hypothyroidism, cirrhosis,
malnutrition,
and chronic thyroiditis.Normal Adult Range: 4 - 12 ug/dl Optimal
Adult
Reading: 8 ug/dlT3-UPTAKEThis test is an indirect measurement of
unsaturated
thyroxine binding globulin in the blood. Increased levels are found in
hyperthyroidism, severe liver disease, metastatic malignancy, and
pulmonary
insufficiency. Decreased levels are found in hypothyroidism, normal
pregnancy,
and hyperestrogenis status.Normal Adult Range: 27 - 47% Optimal Adult
Reading:
37 %FREE T4 INDEX (T7)This index is a calculation used to correct
the
estimated total thyroxine for the amount of thyroxine binding globulin
present. It uses the T4 value and the T3 uptake ratio.Normal Adult Range: 4 - 12 Optimal Adult
Reading:8THYROID-STIMULATING HORMONE (TSH)TSH, produced by the anterior pituitary
gland,
causes the release and distribution of stored thyroid hormones. When T4
and T3 are too high, TSH secretion decreases, when T4 and T3 are low,
TSH
secretion increases. Increased TSH levels are seen in primary
hypothyroidism,
thyrotropin producing tumors, and thyrotoxicosis. Decreased levels are
seen in hyperthyroidism and secondary and tertiary hypothyroidism.Normal Adult Range: .5 - 6 miliIU/L Optimal
Adult
Reading: 3.25 miliU/LOTHER GLUCOSE (FASTING)Glucose, formed by the digestion of
carbohydrates
and the conversion of glycogen by the liver is the primary source of
energy
for most cells. Insulin, glucagon, thyroid hormone, liver enzymes and
adrenal
hormones regulate it. It is elevated in diabetes, liver disease,
obesity,
pancreatitis, steroids, stress, or diet. Low levels may be indicative
of
liver disease, overproduction of insulin, hypothyroidism, or alcoholism.Normal Adult Range: 60 - 115 mg/dl Optimal
Adult
Reading: 87.5IRON, TOTALIron is necessary for the formation of some
proteins,
hemoglobin, myoglobin, and cytochrome. Also it is necessary for oxygen
transport, cellular respiration and peroxide deactivation. Low levels
are
seen in many anemias, copper deficiencies, low vitamin C intake, liver
disease, chronic infections, high calcium intake and women with heavy
menstrual
flows. High levels are seen in hemochromitosis, liver damage,
pernicious
anemia and hemolytic anemia.Normal Adult Range: 30 – 170 mcg/dl Optimal
Adult
Reading: 100

Searching for ways to
deal
with the depression, the frustrations, the questions about lupus, I
joined
a support group online. LUPIES has been a wonderful gift. I
have learned more from the information I found on the support web site
from other sufferers of Lupus than I did from my doctor.

Thank you fellow
Lupies!
With a very special thank you to Deanna!May your days be pain free!

Searching for ways to deal
with
the depression, the frustrations, the questions about lupus, I joined a
support group online. LUPIES has been a wonderful gift. I
have
learned more from the information I found on the support web site from
other sufferers of Lupus than I did from my doctor.

Thank you fellow
Lupies!
May your days be pain free!

Contact the Lupus Foundation of
America
or the local Chapter that serves your area for more information about
lupus,
or the programs and services the LFA offers including support group
information
and physician referral.Lupus Foundation of America., Inc.1300 Piccard Drive, Suite 200Rockville, MD 20850-4303301-670-9292 800-558-0121http://www.lupus.orgInformation gathered from :

When is it ordered?

The CBC is a very common test. Many people have a CBC performed when they have a routine health examination. If a person is healthy and has results that are within normal limits, then he or she may not require another CBC until their health status changes or until their doctor feels that it is necessary.

A CBC may be ordered when a person has any number of signs and symptoms that may be related to disorders that affect blood cells. When an individual has fatigue or weakness or has an infection, inflammation, bruising, or bleeding, a doctor may order a CBC to help diagnose the cause and/or determine its severity.

When a person has been diagnosed with a disease known to affect blood cells, a CBC will often be ordered on a regular basis to monitor their condition. Likewise, if someone is receiving treatment for a blood-related disorder, then a CBC may be performed frequently to determine if the treatment is effective.

Some therapies, such as chemotherapy, can affect bone marrow production of cells. Some medications can decreaseWBC counts overall. A CBC may be ordered on a regular basis to monitor these drug treatments.

What does the test result mean?

A doctor typically evaluates and interprets results from the components of the CBC together. Depending on the purpose of the test, a number of additional or follow-up tests may be ordered for further investigation.

The following tables briefly and generally explain what the result for each component of the CBC may mean.

Mirrors MCV results; macrocytic RBCs are large so tend to have a higher MCH.

MCHC

Mean Corpuscular Hemoglobin Concentration

May be low when MCV is low; decreased MCHC values (hypochromia) are seen in conditions such as iron deficiency anemia and thalassemia.

Increased MCHC values (hyperchromia) are seen in conditions where the hemoglobin is more concentrated inside the red cells, such as autoimmune hemolytic anemia, in burn patients, and hereditary spherocytosis, a rare congenital disorder.

RDW (Not always reported)

RBC Distribution Width

Low value indicates uniformity in size of RBCs

Indicates mixed population of small and large RBCs; immature RBCs tend to be larger. For example, in iron deficiency anemia or pernicious anemia, there is high variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis), causing an increase in the RDW.

In the setting of anemia, a low reticulocyte count indicates a condition is affecting the production of red blood cells, such as bone marrow disorder or damage, or a nutritional deficiency (iron, B12 or folate)

In the setting of anemia, a high reticulocyte count generally indicates peripheral cause, such as bleeding or hemolysis, or response to treatment (e.g., iron supplementation for iron deficiency anemia)

Indicates average size of platelets is small; older platelets are generally smaller than younger ones and a low MPV may mean that a condition is affecting the production of platelets by the bone marrow.

Indicates a high number of larger, younger platelets in the blood; this may be due to the bone marrow producing and releasing platelets rapidly into circulation.

Is there anything else I should know?

Many different conditions can result in increases or decreases in the cell populations. Some of these conditions may require treatment, while others may resolve on their own.

Recent blood transfusions affect the results of the CBC.

Normal CBC values for babies and children are different from adults. The laboratory will supply the reference ranges for various age groups, and the doctor will take these into consideration when interpreting data.

Hi Marissa,I'm Paula..I really like your blog. I have SLE and now have some evidence of kidney involvement. I came across your blog while doing some research on lupus nephritis. I have a couple of Etsy shops with blogs and this is one of them. I donate a small portion of my profit to The Lupus Foundation. I also have a Facebook group called "Lupus Buddies" Look us up if you're interested~! I also belong to several other lupus groups and recently participated in a lupus awareness video. It should be on my blog somewhere in the vicinity of July-August, I believe. You are more than welcome to view it.. I have joined your blog and look forward to reading more about you!Kindest Regards,Paula Dee

It is funny that you just found my blog because I have a Mrs.lupus facebook site and I put your bracelets up on there and found them a few days ago. They are fab! Here is a link to my page, feel free to post your creations on my site. I am so sorry about your kidney involvement, sending love and prayers your way. xoxo https://www.facebook.com/Mrs.lupus

Hello everybody i am so happy to share this testimony on how Dr Molemen was able to heal me from HIV Disease, well i was detected positive on 23th may 2013, and ever since i have been looking for a way to treat and cure this disease from me, but all ways i try there was no solution, few weeks ago i saw a testimony of some people on how Dr Molemen was able to cure them from HIV disease, still on i heard about it on media when a young lady also gave her testimony about this same Dr, well left with no hope i message Dr Molemen telling him all my problem, he told me what we where going to do, that he was going to send me a portion which i am going to take, and after which i took this herb portion he sent to me, he told me to go back to the hospital for check up and after i have done that i should come and tell him the good news result, at first when i saw the message i was so shock and still did not believed i will be cured, well friend to make my story short i am HIV negative now after many time of sorrow, i am Negative, and my sickness are gone, i thank God for leading me to this man....you can email him on (drmolemenspiritualtemple@gmail.com) or call him on +2347036013351, he can be of help to you on any problem.. Sir may God Bless You.

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My Story

I am not sure when my first symptoms of lupus started, but I remember being sick intermittently. I would have symptoms that would come and go. I would always feel worse in the winter, but I would just think I was constantly having different viruses. I would get rashes on and off for years, but I ignored them and just thought they would go away, and luckily they would. I started to take over the counter anti-inflammatories daily, and that would help curb my pain. I always had something to blame my symptoms on, something other than a serious disease. Six years ago (or so, brain fog)my internist at the time put together all of my symptoms and told me she thought I had lupus, and scheduled me for an appointment with a Rheumatologist. Due to the appointment being months away, by the time it came, I was no longer feeling bad. I stupidly canceled the appointment. I was not educated about lupus, and refused to learn anything about it due to fear. I did not realize that this doctor was unlike so many other doctors, in the fact that she was educated on lupus, while so many others are not. And that she was actually listening to me and really hearing me. I tried to ignore my symptoms, but it all came to a head 6 years ago when I developed graves disease (autoimmune thyroid disease, overactive thyroid)I became extremely ill and dropped 30lbs. I was not overweight to begin with, and it was dramatic. I finally got diagnosed with graves, which is not hard to diagnose, but it seems that docs even have a problem doing proper blood tests for that disease. Then I started having trouble walking, then I could not walk. My doctors were not listening to me, so I switched doctors a couple of times, and finally went to a rheumy. This is where most people without lupus think our journey ends, and our diagnosis and treatment for lupus begins, but unfortunately it is just the beginning of not being listened to. I found out the hard way that not all rheumies are created equally, meaning some should not be practicing medicine. This doctor, who shall remain nameless, due to me not wanting a defamation of character law suit on my hands, was so awful I do not think I could capture her cruelty in writing! Keep in mind that I could not walk and she would not do anymore blood testing on me or listen to me. She lied and said I had a negative ANA, when it was positive and she acted like I was wasting her time, like I was a hypochondriac (A person who is abnormally anxious about their health.)She actually ended up calling me due to some complaints and apologized for "being indifferent" which was an understatement. She went on to explain why she said my ANA was negative when it was positive, and that she thought I was so sick I needed to be hospitalized!! Yeah you read that correctly, she sent me away like I was just there because I was enjoying myself, but she actually thought I was extremely ill. My thought was, how does she treat people who do not look as sick as I do and can walk!! She proceeded to ask me if I was sure I wanted to continue to see another rheumy!! Of course there are many others with awful experiences with her and many other rheumies. Why are there so many "indifferent" rheumies? I wish I knew but many of us have the same story. I decided to get a lupus diagnosis or be told it wasn't lupus from the University of Pittsburgh's Lupus Center. I saw a beautiful rheumy there! She listened to everything, she looked at all of my pictures of rashes, ulcers,inflammation, she gave me a proper exam and actually touched me! She watched me walk or lack of walking, she sent me for 12 viles of blood. I was so prepared for this visit, because with lupus you have to be. I kept a list of all of my symptoms, we were both thorough. She told me due to my other blood tests and my big folder of medical history, before I even left the examining room that I had lupus or undifferentiated connective tissue disease. Both are treated the same way. She gave me lupus meds and sent me for her blood tests. I had just gotten out of the hospital at that point and I begged the doctor to let me out due to that important appointment. I see another local rheumy now because Pittsburgh is 4 hours away from me, and I am too sick most of the time to travel so far. This was my journey to a lupus diagnosis.